Nationwide trends in urolithiasis and stone procedures in Iceland.

OBJECTIVE

This study aimed to assess nationwide trends in registered upper urinary tract stone disease and stone-related procedures in Iceland.

MATERIAL AND

METHODS

We performed a nationwide retrospective population-based study of adults aged 18 years or older with International Classification of Diseases, 10th revision codes N20, N22 or N23 in national hospital and specialist-care data from 2010 to 2024. Crude and age-standardised incidence rates were calculated per 100,000 adults. Stone-related procedures from 2013 to 2024 were identified using Nordic Classification of Surgical Procedures codes. Temporal trends were analysed using negative binomial regression with population offsets.

RESULTS

The cohort included 9,492 adults. Registered incidence ranged from 221 to 260 per 100,000 adults and remained stable (95% confidence interval -0.6% to 0.6%; p = 0.914); age standardisation and alternative case definitions gave the same conclusion. Among patients first registered from 2013 onward, 2,432/7,766 (31%) underwent a stone-related procedure. The procedure rate increased from 124.3 to 236.5 per 100,000 adults, corresponding to a 6% annual increase. Ureteroscopy accounted for 10% of procedure registrations in 2013-2016 and 30% in 2021-2024, while shock wave lithotripsy remained the most common procedure.

CONCLUSIONS

Registered upper urinary tract stone incidence remained stable, but treatment activity increased substantially. Ureteroscopy use rose rapidly, although shock wave lithotripsy remained the predominant procedure.